Cognitive Behavioral Therapy with Adults I

PSYCHOLOGY 862: COGNITIVE BEHAVIORAL THERAPY WITH ADULTS I

Instructors: Keith Renshaw Michelle Gryczkowski Phone: (703) 993-5182 Email: [email protected] Office Hours: Thu 1:00-2:00 (clinic), by appt

Course Description: This course is designed to instruct you in the theory, principles, and application of cognitive-behavioral therapy for a variety of psychological problems. From a theoretical perspective, we will review behavioral theory, the cognitive model of emotion, and the basic steps in forming a cognitive-behavioral conceptualization. From an applied perspective, we will review the principles of conducting cognitive-behavioral therapy, basic behavioral and cognitive techniques, and how to apply these techniques using a coherent cognitive-behavioral conceptualization. We will also focus specifically on the application of cognitive-behavioral theory and therapy to depression, anxiety disorders, and couples’ distress.

This course will utilize several modes of learning, including readings, lecture, discussion, example video/audiotapes, homework, role plays, and supervision of actual clinical cases. Each aspect of the coursework is essential to the development of your ability to apply cognitive-behavioral therapy. Initially, class time will be comprised of didactic instruction, but as the semester progresses, we will begin to split class time between didactics and group supervision of cases. I will not use tests or other methods to grade you, and the grades will simply be “Satisfactory” or “No Credit.” This should not, however, give you the impression that you can “slide by” on readings or assignments. Receiving credit for the course will require (a) completion of all didactic elements of the course and (b) appropriate and ethical conduct in the delivery of therapy. This includes record-keeping and other associated clinic duties.

The course is not intended to convey that cognitive-behavioral therapy is the only acceptable therapy to practice. Rather, it is intended to inform you of (a) the problems for which cognitive-behavioral therapy has been shown to be efficacious and/or effective, (b) the steps and techniques involved in conducting cognitive-behavioral therapy, and (c) the flexibility of this therapy when it is based on a coherent case conceptualization. A list of treatment manuals for various psychological problems will be provided for your reference, but you will not be expected to learn each manual. Rather, you will learn the theory that underlies the application of the therapy to any problem.

Course Goals: 1. To foster the development of your professional identity as a therapist. 2. To learn the basic tenets and principles of behavioral theory and cognitive theory. 3. To learn how to develop a comprehensive and cohesive cognitive-behavioral case conceptualization. 4. To understand how issues of diversity (e.g., age, race, ethnicity, culture, sexual orientation, etc.) can be incorporated into a cognitive-behavioral conceptualization. 5. To learn behavioral and cognitive therapy techniques, and to develop a basic level of competence in applying these techniques in practice situations (e.g., role plays). 6. To be able to develop a basic treatment plan based on a cognitive-behavioral case conceptualization. 7. To begin to be able to carry out a basic cognitive-behavioral treatment plan, understanding how the case conceptualization will drive all therapeutic activity. 8. To appreciate the importance of the therapeutic relationship to cognitive-behavioral therapy. 9. To understand existing knowledge regarding the potential influence of race, ethnicity, age, sex, sexual orientation, and other forms of diversity on the effects of treatment and on treatment delivery.

Class Cancellation Policy: The instructor will notify the class of any cancellations or changes to the schedule by email.

Disabilities: If you are a student with disability and you need academic accommodations, please see me and contact the Disability Resource Center (DRC) at 709-993-2474. All academic accommodations must be arranged through that office. Please note that accommodations MUST BE MADE BEFORE grades are assigned.

Honor Code: Mason is an Honor Code university; please see the Office for Academic Integrity website (http://oai.gmu.edu/) for a full description of the code and the honor committee process. CLASS SCHEDULE AND IMPORTANT DATES

9/6 Final Add Date 9/30 Final Drop Date

Week Topic Readings

Beutler (2009) Introduction Butler et al. (2006) 9/1 Structure in Therapy Beck (2011): Ch. 1, 2, 4, 5, 7 Functional Analysis Dobson (2016a) Mazzucchelli et al. (2009) Behavioral Theory of Depression Martell et al. (2001) Ch. 2 9/8 Behavioral Activation Beck (2011): Ch. 15 Relaxation Techniques Craske & Barlow (2006): Ch. 5 Asnaani et al. (in press) Behavioral Theory of Anxiety 9/15 Craske et al. (2014) Exposure Therapy Steketee (1993): Ch 8 Beck (2011): Ch. 3 pp. 137-140, 158-162, 198- 9/22 Cognitive Theory 205, 228-233 Beck (2005): pp. 17-39 9/29 Automatic Thoughts Beck (2011): Ch. 9-11 Beck (2011): Ch. 12 10/6 Automatic Thoughts (cont.) Beck (2005): pp. 209-226; Ch. 11 Automatic Thoughts (cont.) Beck (2011): Ch. 13; Ch. 14 10/13 Intermediate and Core Beliefs Automatic Thoughts (cont.) Beck (2005): pp. 63-68; 77-85 10/20 Intermediate and Core Beliefs (cont.) Beck (2011): Ch. 16 10/27 No Class Meeting: Individual/Group Supervision (ABCT) Persons (2005) 11/3 Integrated Cognitive-Behavioral Conceptualization Kuyken et al. (2008) Barlow (2008): Ch. 5 Treatment Planning Beck (2011): Ch. 17-20 11/10 Course of Treatment pp. 284-286, 292-299 Voss Horrell (2008) Integrating Cultural Considerations 11/17 Hays (2006): pp. 3-13 Skill Review Okazaki & Tanaka-Matsumi (2006) 11/24 Thanksgiving Holiday – No Class Balsam et al. (2006) Integrating Cultural Considerations 12/1 Laidlaw et al. (2004) Skill Review Organista (2000) (skim pp. 282-286) Prepare CB conceptualization Research on CBT Johnsen & Friborg (2015) 12/8 Case Conceptualizations Dobson (2016b) Waltman et al. (2016) Group Supervision Beck (2011): Ch. 21 12/15 Winter Break Planning for Active Cases Reading List

Required Texts Barlow, D. H. (2008). Clinical handbook of psychological disorders: A step-by-step treatment manual (4 th ed.). New York: Guilford. Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2 nd ed.). New York: Guilford. Beck, J. S. (2005). Cognitive therapy for challenging problems: What to do when the basic don’t work. New York: Guilford.

Optional Supplemental Texts Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. H. (2010). Exposure therapy for anxiety: Principles and practice. New York: Guilford. Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. New York: W. W. Norton. Steketee, G. S. (1993). Treatment of obsessive-compulsive disorder. New York: Guilford.

Articles/Chapters/Workbooks Asnaani, A., McLean, C. P., & Foa, E. B. (in press). Updating Watson & Marks (1971): How has our understanding of the mechanisms of extinction learning evolved and where is our field going next? Behavior Therapy. Balsam, K. F., Martell, C. P., & Safren, S. A. (2006). Affirmative cognitive-behavioral therapy with lesbian, gay, and bisexual people. In P. A. Hays, & G. Y. Iwamasa (Eds.), Culturally responsive cognitive-behavioral therapy (pp. 223-243). Washington, D.C.: American Psychological Association. Beutler, L. E. (2009). Making science matter in clinical practice: Redefining psychotherapy. Clinical Psychology Science and Practice, 16, 301-317. Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavior therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17-31. Craske, M. G., & Barlow, D. B. (2006). Mastery of your anxiety and worry (2 nd ed.): Workbook. New York: Oxford. Craske, M. G., Treanor, M., Conway, C. C., Zbonizek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. Dobson, K. S. (2016a). New frontiers in cognitive-behavioral therapy for depression. International Journal of Cognitive Therapy, 9, 107-123. Dobson, K. S. (2016b). The efficacy of cognitive-behavioral therapy for depression: Reflections on a critical discussion. Clinical Psychology Science and Practice, 23, 123-125. Hays, P. A. (2006). Introduction: Developing culturally responsive cognitive-behavioral therapies. In P. A. Hays, & G. Y. Iwamasa (Eds.), Culturally responsive cognitive-behavioral therapy (pp. 3-19). Washington, D.C.: American Psychological Association. Johnsen, T. J., & Friborg, O. (2015). The effects of cognitive-behavioral therapy as an anti-depressive treatment is falling: A meta-analysis. Psychological Bulletin, 141, 747-768. Kuyken, W., Padesky, C. A., & Dudley, R. (2008). The science and practice of case conceptualization. Behavioural and Cognitive Psychotherapy, 36, 757-768. Laidlaw, K., Thompson, L. W., & Gallagher-Thompson, D. (2004). Comprehensive conceptualization of cognitive- behaviour therapy for late life depression. Behavioural and Cognitive Psychotherapy, 32, 389-399. Mazzucchelli, T., Kane, R., & Rees, C. (2009). Behavioral activation treatments for depression in adult: A meta- analysis and review. Clinical Psychology: Science and Practice, 16, 383-411. Okazaki, S., & Tanaka-Matsumi, J. (2006). Cultural considerations in cognitive-behavioral assessment. In P. A. Hays, & G. Y. Iwamasa (Eds.), Culturally responsive cognitive-behavioral therapy (pp. 247-266). Washington, D.C.: American Psychological Association. Organista, K. C. (2000). Latinos. In J. R. White & A. S. Freeman (Eds.), Cognitive-behavioral group therapy for specific problems and populations (pp. 281-303). Washington, D. C.: American Psychological Association. Persons, J. B. (2005). Empiricism, mechanism, and the practice of cognitive-behavior therapy. Behavior Therapy, 36, 107-118. Voss Horrell, S. C. (2008). Effectiveness of cognitive-behavioral therapy with adult ethnic minority clients: A review. Professional Psychology: Research and Practice, 39, 160-168. Waltman, S. H., Creed, T. A., & Beck, A. T. (2016). Are the effects of cognitive behavior therapy for depression falling? Review and critique of the evidence. Clinical Psychology Science and Practice, 23, 113-122.

Optional Supplemental Readings Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markley, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658-670. Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295-304. Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive-behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377-384.